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Chapter 30. Fungal Rhinosinusitis

Which of the following portends a better prognosis in acute invasive fungal sinusitis?

A. Lack of visual or neurological symptoms

B. Aspergillus as causative fungus

C. Aggressive open-approach resection

D. Diabetic patient in ketoacidosis

Which of the following is true regarding allergic fungal rhinosinusitis?

A. Oral antifungals may reduce postoperative mucosal inflammation and recurrence of disease.

B. Positive fungal cultures are required for diagnosis and directed antifungal therapy.

C. Surgery is usually not necessary as polyps and mucin respond readily to appropriate medical management.

D. More than IgE-mediated hypersensitivity, robust T helper 2-driven adaptive immune response to fungal antigen drive the AFS inflammatory cascade.

Which is the best treatment for invasive sinusitis of hyaline mold with regular septate hyphae branching at acute angles?

A. IV isavuconazole

B. Liposomal amphotericin B

C. IV voriconazole

D. IV piperacillin-tazobactam

How is chronic invasive sinusitis clinically differentiated from acute invasive fungal sinusitis?

A. Tissue biopsy

B. Time course of symptoms

C. Degree of extrasinus invasion

D. Fungal stain and culture

Which of the following is false in acute invasive fungal sinusitis?

A. Oral antifungals have no role in the treatment of invasive fungal sinusitis.

B. Mucor growth is optimized in acidotic conditions due to an increased availability of serum iron.

C. Infection with Mucorales spp. is more destructive and fatal than Aspergillus spp.

D. Invasive disease by P. boydii is resistant to amphotericin B and requires voriconazole.

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